LELisa Edinger
@lisaedinger1
Detail-oriented healthcare professional with expertise in prior authorization.
United StatesWhat I'm looking for
I am a detail-oriented healthcare professional with extensive experience in prior authorization, insurance verification, medical billing, and patient advocacy. My proven ability to foster positive relationships with healthcare providers, patients, and insurance companies has been instrumental in ensuring regulatory compliance and efficient workflow management.
Throughout my career, I have honed my skills in EHR/EMR systems and remote operations, delivering consistent, high-quality service in dynamic healthcare environments. My role as a Prior Authorization Specialist at Cigna Healthcare allowed me to enhance workflow efficiency by streamlining documentation processes, while my experience at Cardinal Health involved coordinating insurance benefit verifications and ensuring compliance with payer policies.
Experience
Work history, roles, and key accomplishments
Prior Authorization Specialist
Cigna Healthcare
Mar 2024 - Jun 2025 (1 year 3 months)
Verified patient eligibility and authorization requirements according to payer policies and clinical guidelines. Processed prior authorizations for medications, procedures, and services, ensuring accuracy and timely follow-up.
Prior Authorization Specialist
Cardinal Health
Feb 2022 - Jan 2024 (1 year 11 months)
Coordinated insurance benefit verifications and initiated prior authorization requests via phone, fax, and online portals. Ensured compliance with payer policies, state regulations, and HIPAA standards.
Medical Customer Service Representative
Infocision Management
Sep 2018 - Jan 2022 (3 years 4 months)
Handled customer inquiries, resolved billing disputes, and updated account records to ensure accurate information management. Reviewed and processed medical claims, ensuring alignment with insurance guidelines and coverage eligibility.
Education
Degrees, certifications, and relevant coursework
Lifelong Learning Choices
High school Diploma, General Studies
Completed high school education, obtaining a diploma. Focused on foundational subjects to prepare for future career endeavors.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Job categories
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